Dosimetric Study of Three Different Irradiation Techniques in Graves' Ophthalmopathy Radiotherapy_West China Medical Journal

Authors：

 HeDan , FuBo

Department of Oncology, Nuclear Industry 416 Hospital, Chengdu, Sichuan 610000, P. R. China;

Corresponding?author：

Keywords：

Graves' ophthalmopathy; Thyroid-associated ophthalmopathy; Conventional radiotherapy; Conformal radiotherapy; Dose contrast

DOI：

10.7507/1002-0179.201600548

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Objective To compare the radiation dose distribution in irradiated target area and organs at risk among conventional radiotherapy, conformal radiotherapy and semi-field conformal radiotherapy in Graves' ophthalmopathy patients. Methods Thirty patients with Grave's ophthalmopathy treated between January 2010 and December 2012 were included in this study.CT scan was performed to obtain images of each patients; three-dimensional planning system (3D-TPS) was done to design conventional radiotherapy, conformal radiotherapy and semi-field conformal radiotherapy for each patient.Then, we counted the standard deviation of study parameters for each radiotherapy technique, and the results were compared among the three groups. Results Average irradiation dose in target area of patients accepting conventional irradiation, conformal irradiation and semi-field conformal irradiation therapy was not significantly different (P > 0.05).V₉₅ and the conformity index values of conformal irradiation and semi-field conformal irradiation therapy were better than those of the conventional irradiation therapy (P < 0.001), while no significant difference between conformal irradiation and semi-field conformal irradiation therapy was detected (P > 0.05).Patients accepting conventional irradiation got the highest cumulative irradiation dose in eye lens, while patients accepting semi-field conformal irradiation therapy got the lowest irradiation dose in eye lens, and the differences were significant (P < 0.05).Patients accepting conventional irradiation got the highest cumulative irradiation dose in pituitary, while cumulative irradiation dose in pituitary in patients accepting conformal irradiation and semi-field conformal irradiation therapy was not significantly different (P > 0.05). Conclusions Conformal irradiation and semi-field conformal irradiation techniques are superior to conventional irradiation technique, with a better target conformal degree and higher does distribution in target area, as well as a lower radiation dose in normal tissues surrounding target area.Semi-field conformal irradiation technique has a better performance than conformal irradiation therapy in eye lens protection.

Citation： HeDan, FuBo. Dosimetric Study of Three Different Irradiation Techniques in Graves' Ophthalmopathy Radiotherapy. West China Medical Journal, 2016, 31(12): 2000-2003. doi: 10.7507/1002-0179.201600548 Copy

1.	金柯, 朱豫.甲狀腺相關眼病患者干眼病患病率及特征分析[J].眼科新進展, 2015, 35(5):473-475.
2.	Bartalena L, Marcocci C, Chiovato L, et al. Orbital cobalt.irradiation combined with systemic corticosteroids:for Graves' ophthahnopathy[J]. J Clin Endocrinol Metab, 1983, 56(6):1139-1141.
3.	Bartalena L, Baldeschi L, Dickinson AJ, et al. Consensus statement of the European group on Graves' orbitopathy (EUGOGO) on management of Graves' orbitopathy[J]. Thyroid, 2008, 18(3):333-346.
4.	Petersen IA, Kriss JP, McDougall IR, et al. Prognostic factors in the radiotherapy of Graves' orbitopathy[J]. Int J Rad-iat Oncol Biol Phys, 1990, 19(2):259-264.
5.	Staar S, Muller RP, Hammer M, et al. Results and prognostic factors in retrobulbar radioth erapy combined with systemic corticost eriods for endocrine oribtopathy (Graves' disease)[J]. Front Radiat T her Oncol, 1997, 30:206-217.
6.	Bartalena L, Marcocci C, Gorman CA, et al. Orbital radiotherapy for Graves'opht halmopat hy:useful or useless? Safe or dangerous[J]. J Endocrinol Invest, 2003, 26(1):5216.
7.	Blank LE, BarendsenGW, Prummel MF, et al. Probable risk of tumor induction after retroorbital Irradiation for Graves' ophthahnopathy[J]. Radiotheroncol, 1996, 40(2):187-188.
8.	Snijders-Keilholz A, DeKeizer RJ, Gosling BM, et al. Probable risk of tumor induction after retro=orbital irradiation for Graves' ophthahnopathy[J]. Radiother oncol, 1996, 38(1):69-71.
9.	孟盈, 周慧芳.甲狀腺相關眼病流行病學和臨床特征[J].中國實用內科雜志, 2015, 35(7):566-568.
10.	BahnRS, Heufelder AE. Pathogenesis of Graves' ophthalmopath[J]. N Engl J Med 1993, 329(20):1468-1475.
11.	李星辰, 辛論, 徐海英, 等.甲狀腺相關眼病的治療[J].協和醫學雜志, 2013, 4(2):185-190.
12.	Luigi B, Claudio M, Aldo P, et al. Editorial:orbital radiotherapy for Graves' ophthalmopathy[J]. JCEM, 2004, 89(1):13214.
13.	劉芳, 朱豫, 張珂, 等.激素沖擊聯合放射治療重度活動期甲狀腺相關眼病療效觀察[J].新鄉醫學院學報, 2016, 33(7):623-625.
14.	蒙渡, 陳利紅, 劉銳, 等.三維適形放射治療Graves眼病的臨床觀察[J].安徽醫科大學學報, 2013, 48(8):964-966.
15.	朱京麗, 毛凱. Graves眼病球后放射治療劑量分布的研究[J].中日友好醫院學報, 2002, 16(4):207-210.
16.	Marcooci C, Bartalena L, Roberto R, et al. Long-term safety of orbital radiotherapy for Graves' ophthalmopathy[J]. JCEM, 2003, 88(8):3561-3566.
17.	Marquez SD, Lum BL, Mcdougall IR, et al. Long-term results of irradiation for patients with progressive Graves' ophthalopathy[J]. Int J Radiat Oncol Biol Phys, 2001, 51(3):766-744.
18.	Tsujino K, Hirota S, Hagiwara M, et al. Clinical out comes of orbital irradiation combined or without systemic high-dose or pulsed corticosteroids for Graves' ophthalmopathy[J]. Int J Radiat Oncol Biol Phys, 2000, 48(3):857-864.

1. 金柯, 朱豫.甲狀腺相關眼病患者干眼病患病率及特征分析[J].眼科新進展, 2015, 35(5):473-475.
2. Bartalena L, Marcocci C, Chiovato L, et al. Orbital cobalt.irradiation combined with systemic corticosteroids:for Graves' ophthahnopathy[J]. J Clin Endocrinol Metab, 1983, 56(6):1139-1141.
3. Bartalena L, Baldeschi L, Dickinson AJ, et al. Consensus statement of the European group on Graves' orbitopathy (EUGOGO) on management of Graves' orbitopathy[J]. Thyroid, 2008, 18(3):333-346.
4. Petersen IA, Kriss JP, McDougall IR, et al. Prognostic factors in the radiotherapy of Graves' orbitopathy[J]. Int J Rad-iat Oncol Biol Phys, 1990, 19(2):259-264.
5. Staar S, Muller RP, Hammer M, et al. Results and prognostic factors in retrobulbar radioth erapy combined with systemic corticost eriods for endocrine oribtopathy (Graves' disease)[J]. Front Radiat T her Oncol, 1997, 30:206-217.
6. Bartalena L, Marcocci C, Gorman CA, et al. Orbital radiotherapy for Graves'opht halmopat hy:useful or useless? Safe or dangerous[J]. J Endocrinol Invest, 2003, 26(1):5216.
7. Blank LE, BarendsenGW, Prummel MF, et al. Probable risk of tumor induction after retroorbital Irradiation for Graves' ophthahnopathy[J]. Radiotheroncol, 1996, 40(2):187-188.
8. Snijders-Keilholz A, DeKeizer RJ, Gosling BM, et al. Probable risk of tumor induction after retro=orbital irradiation for Graves' ophthahnopathy[J]. Radiother oncol, 1996, 38(1):69-71.
9. 孟盈, 周慧芳.甲狀腺相關眼病流行病學和臨床特征[J].中國實用內科雜志, 2015, 35(7):566-568.
10. BahnRS, Heufelder AE. Pathogenesis of Graves' ophthalmopath[J]. N Engl J Med 1993, 329(20):1468-1475.
11. 李星辰, 辛論, 徐海英, 等.甲狀腺相關眼病的治療[J].協和醫學雜志, 2013, 4(2):185-190.
12. Luigi B, Claudio M, Aldo P, et al. Editorial:orbital radiotherapy for Graves' ophthalmopathy[J]. JCEM, 2004, 89(1):13214.
13. 劉芳, 朱豫, 張珂, 等.激素沖擊聯合放射治療重度活動期甲狀腺相關眼病療效觀察[J].新鄉醫學院學報, 2016, 33(7):623-625.
14. 蒙渡, 陳利紅, 劉銳, 等.三維適形放射治療Graves眼病的臨床觀察[J].安徽醫科大學學報, 2013, 48(8):964-966.
15. 朱京麗, 毛凱. Graves眼病球后放射治療劑量分布的研究[J].中日友好醫院學報, 2002, 16(4):207-210.
16. Marcooci C, Bartalena L, Roberto R, et al. Long-term safety of orbital radiotherapy for Graves' ophthalmopathy[J]. JCEM, 2003, 88(8):3561-3566.
17. Marquez SD, Lum BL, Mcdougall IR, et al. Long-term results of irradiation for patients with progressive Graves' ophthalopathy[J]. Int J Radiat Oncol Biol Phys, 2001, 51(3):766-744.
18. Tsujino K, Hirota S, Hagiwara M, et al. Clinical out comes of orbital irradiation combined or without systemic high-dose or pulsed corticosteroids for Graves' ophthalmopathy[J]. Int J Radiat Oncol Biol Phys, 2000, 48(3):857-864.

West China Medical Journal

Dosimetric Study of Three Different Irradiation Techniques in Graves' Ophthalmopathy Radiotherapy

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